scholarly journals A review of paediatric soft tissues masses referred to a tertiary musculoskeletal sarcoma centre

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200790
Author(s):  
Catriona Reid ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Soft Tissues ◽  
Malignant Lesion ◽  
Malignant Tumour ◽  
Benign Tumour ◽  
Neoplastic Lesion ◽  
Soft Tissue Masses ◽  
Oncology Unit ◽  
Musculoskeletal Oncology

Objectives: To determine the differential diagnosis of musculoskeletal soft tissue masses in children referred to a specialist musculoskeletal oncology unit. Methods: All children (0–18 y) referred to a specialist musculoskeletal oncology unit over a 20-month period (September 2018–May 2020) were retrospectively reviewed. Demographic data and referral diagnoses were obtained from the electronic patient notes. MRI findings and histopathological results were recorded. The comparison of non-neoplastic, benign neoplastic and malignant diagnoses at the point of referral and final diagnosis was determined. Results: 116 patients were included, 60 (51.7%) males and 56 (48.3%) females with mean age of 10.6 years (3 months–18 years). 69 (59.5%) patients were referred with a suspected sarcoma, 29 (25.0%) with a suspected benign tumour and 18 (15.5%) with a non-neoplastic lesion. A diagnosis was achieved by histological assessment in 61 (52.6%) cases, microbiological assessment in 3 (2.6%) or clinical and imaging assessment in 52 (44.8%). 67 (57.8%) cases had non-neoplastic pathology, 39 (33.6%) a benign tumour, 4 (3.4%) an intermediate-grade tumour, 6 (5.2%) a malignant tumour. Conclusions: Although over half of children referred to a specialist musculoskeletal oncology unit were suspected of having a soft tissue sarcoma at referral, only 5.2% were diagnosed with a malignant tumour. Advances in knowledge: Approximately, 6 of 69 (8.7%) children referred to a specialist musculoskeletal oncology unit with a suspected soft tissue sarcoma will have a malignant lesion. Most paediatric soft tissue masses are non-neoplastic, the commonest diagnosis being a vascular malformation.

scholarly journals Extraskeletal Mesenchymal Chondrosarcoma

2018 ◽  
Vol 142 (11) ◽  
pp. 1421-1424 ◽  
Author(s):  
Komal Arora ◽  
Nicole D. Riddle
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Soft Tissues ◽  
Hyaline Cartilage ◽  
Mesenchymal Chondrosarcoma ◽  
Small Cells ◽  
Diagnostic Challenge ◽  
Biphasic Pattern ◽  
Biopsy Specimens ◽  
Extraskeletal Mesenchymal Chondrosarcoma

Extraskeletal mesenchymal chondrosarcoma is a rare soft tissue sarcoma arising from soft tissues, mainly of the lower extremities, meninges, and orbits. It usually presents during the second to third decades of life, and has a slight predominance in females. Histologically, it has a typical biphasic pattern comprising small cells and islands of hyaline cartilage. It can pose a diagnostic challenge in small biopsy specimens where 1 of the 2 components can be absent. The prognosis is extremely variable; survival varies depending on the location of the tumor.

scholarly journals Assessment of Referrals into the Soft Tissue Sarcoma Service: Evaluation of Imaging Early in the Pathway Process

Sarcoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Emma Rowbotham ◽  
Shaheel Bhuva ◽  
Harun Gupta ◽  
Philip Robinson
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Service Evaluation ◽  
Lesion Size ◽  
Imaging Diagnosis ◽  
Local Hospital ◽  
Patient Demographics ◽  
Tertiary Centre ◽  
Soft Tissue Masses ◽  
Malignant Lesions

Purpose. To prospectively evaluate regional referrals into a soft tissue sarcoma service from outside the tertiary centre with local hospital imaging.Materials and Methods. Consecutive referrals were prospectively assessed for: patient demographics, source, referral date, date received by Multidisciplinary Team (MDT), lesion size, local radiology, MDT radiology and final diagnoses. Radiology diagnosis was categorised benign, indeterminate or malignant by consensus. Delays were defined as >10 days.Results. 112 patients were included with high correlation between local and MDT radiology categrorisation and histology (P=0.54andP=0.49, resp.). There was only a trend for MDT radiology diagnosis to downgrade local imaging diagnosis (n=15,P>0.05). 48 cases (43%) had ultrasound and MRI at referral and 20 (18%) ultrasound only. 85% of cases were benign (lipoma most common), 15% malignant (sarcoma most common). Delay occurred in 34% of cases.Discussion. In comparison to previous series these results show a reduction in benign lesions, increased biopsy and malignancy rate for lesions referred to a tertiary centre when imaging is performed and reviewed by local radiologists.Advances in Knowledge. Imaging triage of soft tissue masses can decrease benign referral rates and increase the proportion of indeterminate and malignant lesions referred to specialist centres.

scholarly journals The clinical outcome of pazopanib treatment in Japanese patients with relapsed soft tissue sarcoma: A Japanese Musculoskeletal Oncology Group (JMOG) study

Cancer ◽  
2016 ◽  
Vol 122 (9) ◽  
pp. 1408-1416 ◽  
Author(s):  
Tomoki Nakamura ◽  
Akihiko Matsumine ◽  
Akira Kawai ◽  
Nobuhito Araki ◽  
Takahiro Goto ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Clinical Outcome ◽  
Japanese Patients ◽  
Oncology Group ◽  
Musculoskeletal Oncology

Efficacy and safety of trabectedin for patients with unresectable and relapsed soft‐tissue sarcoma in Japan: A Japanese Musculoskeletal Oncology Group study

Cancer ◽  
2019 ◽  
Vol 126 (6) ◽  
pp. 1253-1263 ◽  
Author(s):  
Hiroshi Kobayashi ◽  
Shintaro Iwata ◽  
Toru Wakamatsu ◽  
Keiko Hayakawa ◽  
Tsukasa Yonemoto ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Efficacy And Safety ◽  
Oncology Group ◽  
Oncology Group Study ◽  
Musculoskeletal Oncology

scholarly journals The Clinical and Radiological Characteristics of Inflammatory Myofibroblastic Tumor Occurring at Unusual Sites

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Xuewei Zeng ◽  
Huayi Huang ◽  
Jun Li ◽  
Jiayou Peng ◽  
Jiaxiong Zhang
Keyword(s):  
Soft Tissue ◽  
Inflammatory Myofibroblastic Tumor ◽  
Soft Tissues ◽  
Malignant Tumors ◽  
Bladder Wall ◽  
Benign Tumors ◽  
Mri Scans ◽  
Soft Tissue Masses ◽  
The Masses ◽  
Radiological Methods

Inflammatory myofibroblastic tumor (IMT) can occur rarely in the soft tissue or joint of the limb. We retrospectively collected IMT cases of these rare sites and analyzed their clinical and imaging appearance. Thirteen cases of IMT were clinically diagnosed and underwent surgical procedures, pathological analyses, and postsurgical follow-up in our two hospitals. Other than one case of IMT of the bladder wall that presented with gross hematuria, none presented with local swelling, fever, or weakness. All the cases of IMT occurring at the bone showed destruction and parosteal soft tissue masses. The boundaries between the mass and normal bone were vague, without calcifications or any periosteal reaction. Five cases of IMF showed continuous enhancement on CT; seven cases demonstrated iso- or hyposignal intensity on T1WI; one case showed hypersignal intensity on T1WI, and eight cases demonstrated a hypersignal intensity signal on T2WI. All the masses located in soft tissues showed clear and sharp boundaries with different sizes of the swelling regions surrounding muscle interspaces. Three cases showed homogeneous enhancement, one case demonstrated heterogeneous enhancement, and two cases showed edge enhancement on enhanced MRI scans. On pathology, all the lesions showed an absence of a pseudocapsule, and four cases of ALK were positive. The radiological manifestations of IMT located at the soft tissue and bones were similar to benign tumors in shape; however, peritumoral edema, parosteal soft tissue, and the invasive rim of IMT are similar to the features of malignant tumors. Different radiological methods should be used to obtain an accurate diagnosis.

Sarcomas of soft tissues and bone and gastrointestinal stromal tumour

2016 ◽  
pp. 844-866
Author(s):  
Alessandro Gronchi ◽  
Angelo P. Dei Tos ◽  
Paolo G. Casali
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Soft Tissues ◽  
Lung Metastases ◽  
Gastrointestinal Stromal Tumour ◽  
Histologic Diagnosis ◽  
Course Quality ◽  
First Line Therapy ◽  
Multidisciplinary Consultation ◽  
Localized Disease

Sarcomas are rare tumours that can arise from bone or a variety of soft tissues in a variety of body sites. Surgery is the treatment mainstay for localized disease. Margins of resection are contingent on accurate histologic diagnosis. Adjuvant chemotherapy is routinely employed in osteosarcoma and Ewing Sarcomas, while it is used only on an individualized basis in high-risk soft tissue sarcoma. Isolated lung metastases from either bone or soft tissue sarcoma are primarily treated by surgery, especially if the disease-free interval is long and the number limited. Otherwise chemotherapy is the first-line therapy and subsequent treatments are decided according to response and disease evolution. Treatment planning should include multidisciplinary consultation to determine optimal therapy, taking into consideration tumour histology, site, and extent of the disease, its natural history and sensitivity to available treatments, surgical challenges and, of course, quality of life.

Epithelioid Sarcoma in the Hand

HAND ◽  
1983 ◽  
Vol os-15 (2) ◽  
pp. 228-230 ◽  
Author(s):  
Sorna Rajan ◽  
Tommy Skau
Keyword(s):  
Differential Diagnosis ◽  
Soft Tissue ◽  
Inflammatory Process ◽  
Benign Lesion ◽  
Initial Period ◽  
Epithelioid Sarcoma ◽  
Malignant Lesion ◽  
Malignant Tumour ◽  
Illustrative Case ◽  
The Third

An illustrative case of epithelioid sarcoma in the hand of a young man, causing considerable diagnostic problems, is presented. Epithelioid sarcoma is a malignant lesion, first described by Enzinger in 1970. Although epithelioid sarcoma is the third commonest soft tissue sarcoma in the upper extremity (Bryan, 1974) it still causes confusion in differential diagnosis, both to the surgeon and to the pathologist. Because of its deceptively harmless appearance during the initial period and its clinical and microscopical similarity to an inflammatory process, it is often mistaken for a benign lesion. The purpose of our paper is to draw attention to this rare malignant tumour. This case illustrates a course similar to those described previously. (Enzinger, 1970: Santiago, 1972).

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